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Pohl M, Greimel P, Klaritsch P, Csapó B, Simonis H, Schneditz D. Feasibility of continuous intra-uterine pressure measurements during amnioreduction in twin-to-twin transfusion syndrome therapy. Placenta 2023; 142:147-153. [PMID: 37801953 DOI: 10.1016/j.placenta.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 08/29/2023] [Accepted: 09/04/2023] [Indexed: 10/08/2023]
Abstract
INTRODUCTION This work explores the feasibility of simultaneous and continuous intra-abdominal, intra-uterine, and arterial blood pressure measurements to examine the hemodynamic perturbation expected during therapeutic amnioreduction and to better understand the protective role of the placenta during that treatment. METHODS Patients with twin-to-twin transfusion syndrome were treated with fetoscopic laser ablation followed by amnioreduction. Intra-abdominal, intra-uterine, and mean arterial pressures were simultaneously recorded during amnioreduction performed in steps of 200 mL. Placental thickness and uterine dimensions were measured before and after amnioreduction by ultrasonography. RESULTS Useful pressure recordings were obtained between volume reduction steps and short hands-off periods in four studies. Median amnioreduction volume was 1400 mL corresponding to a median uterine volume reduction of 1121 mL. Mean intra-uterine pressure significantly fell from 24.8 to 13.6 mmHg (p = 0.011) and intra-abdominal pressure significantly decreased from 13.4 to 9.2 mmHg after amnioreduction (p = 0.015). Uterine pressure recordings revealed transient contractions (A, in mmHg) following individual amnioreduction steps, which increased with fractional amnioreduction (F, no dimension) (A = 17.23*F + 11.81; r = 0.50, p = 0.001). DISCUSSION Simultaneous and continuous measurement of intra-abdominal, intra-uterine, and arterial blood pressures during amnioreduction is feasible. The dynamics reveal transient uterine contractions reaching levels comparable to those seen during childbirth which seem to oppose impending maternal hypovolemia by placental steal at the expense of temporarily reducing placental perfusion pressure and underline the importance of uterine and placental interaction.
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Affiliation(s)
- Maximilian Pohl
- Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010, Graz, Austria
| | - Patrick Greimel
- Research Unit for Fetal Medicine, Division of Obstetrics, Department of Obstetrics and Gynecology, Medical University of Graz, Auenbruggerplatz 14, 8036, Graz, Austria
| | - Philipp Klaritsch
- Research Unit for Fetal Medicine, Division of Obstetrics, Department of Obstetrics and Gynecology, Medical University of Graz, Auenbruggerplatz 14, 8036, Graz, Austria
| | - Bence Csapó
- Research Unit for Fetal Medicine, Division of Obstetrics, Department of Obstetrics and Gynecology, Medical University of Graz, Auenbruggerplatz 14, 8036, Graz, Austria
| | - Holger Simonis
- Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz 5/5, 8036, Graz, Austria
| | - Daniel Schneditz
- Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010, Graz, Austria.
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Taumberger N, Schütz AM, Jeitler K, Siebenhofer A, Simonis H, Bornemann-Cimenti H, Laky R, Tamussino K. Preemptive local analgesia at vaginal hysterectomy: a systematic review. Int Urogynecol J 2022; 33:2357-2366. [PMID: 34870713 PMCID: PMC9427873 DOI: 10.1007/s00192-021-04999-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 09/15/2021] [Indexed: 02/05/2023]
Abstract
INTRODUCTION AND HYPOTHESIS We conducted a systematic review of the effectiveness of local preemptive analgesia for postoperative pain control in women undergoing vaginal hysterectomy. METHODS MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials and the Cochrane Database of Systematic Reviews were searched systematically to identify eligible studies published through September 25, 2019. Only randomized controlled trials and systematic reviews addressing local preemptive analgesia compared to placebo at vaginal hysterectomy were considered. Data were extracted by two independent reviewers. Results were compared, and disagreement was resolved by discussion. Forty-seven studies met inclusion criteria for full-text review. Four RCTs, including a total of 197 patients, and two SRs were included in the review. RESULTS Preemptive local analgesia reduced postoperative pain scores up to 6 h and postoperative opioid requirements in the first 24 h after surgery. CONCLUSION Preemptive local analgesia at vaginal hysterectomy results in less postoperative pain and less postoperative opioid consumption.
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Affiliation(s)
- Nadja Taumberger
- Department of Obstetrics & Gynecology, Medical University of Graz, Auenbruggerplatz 14, 8036, Graz, Austria.
| | - Anna-Maria Schütz
- Department of Obstetrics & Gynecology, Medical University of Graz, Auenbruggerplatz 14, 8036, Graz, Austria
| | - Klaus Jeitler
- Institute of General Practice and Evidence-based Health Services Research, Medical University of Graz, Graz, Austria
| | - Andrea Siebenhofer
- Institute of General Practice and Evidence-based Health Services Research, Medical University of Graz, Graz, Austria
- Institute for General Practice, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Holger Simonis
- Department of Anesthesiology, Emergency Medicine and Critical Care, Medical University of Graz, Graz, Austria
| | - Helmar Bornemann-Cimenti
- Department of Anesthesiology, Emergency Medicine and Critical Care, Medical University of Graz, Graz, Austria
| | - Rene Laky
- Department of Obstetrics & Gynecology, Medical University of Graz, Auenbruggerplatz 14, 8036, Graz, Austria
| | - Karl Tamussino
- Department of Obstetrics & Gynecology, Medical University of Graz, Auenbruggerplatz 14, 8036, Graz, Austria
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Schittek GA, Simonis H, Bornemann-Cimenti H. Pain, nausea, vomiting, thirst, cold, … the challenge of well-being in post-operative patients. Intensive Crit Care Nurs 2021; 66:103090. [PMID: 34119406 DOI: 10.1016/j.iccn.2021.103090] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Gregor Alexander Schittek
- Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria.
| | - Holger Simonis
- Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria
| | - Helmar Bornemann-Cimenti
- Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria
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Szilagyi IS, Ullrich T, Lang-Illievich K, Klivinyi C, Schittek GA, Simonis H, Bornemann-Cimenti H. Google Trends for Pain Search Terms in the World's Most Populated Regions Before and After the First Recorded COVID-19 Case: Infodemiological Study. J Med Internet Res 2021; 23:e27214. [PMID: 33844638 PMCID: PMC8064706 DOI: 10.2196/27214] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 03/04/2021] [Accepted: 04/10/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Web-based analysis of search queries has become a very useful method in various academic fields for understanding timely and regional differences in the public interest in certain terms and concepts. Particularly in health and medical research, Google Trends has been increasingly used over the last decade. OBJECTIVE This study aimed to assess the search activity of pain-related parameters on Google Trends from among the most populated regions worldwide over a 3-year period from before the report of the first confirmed COVID-19 cases in these regions (January 2018) until December 2020. METHODS Search terms from the following regions were used for the analysis: India, China, Europe, the United States, Brazil, Pakistan, and Indonesia. In total, 24 expressions of pain location were assessed. Search terms were extracted using the local language of the respective country. Python scripts were used for data mining. All statistical calculations were performed through exploratory data analysis and nonparametric Mann-Whitney U tests. RESULTS Although the overall search activity for pain-related terms increased, apart from pain entities such as headache, chest pain, and sore throat, we observed discordant search activity. Among the most populous regions, pain-related search parameters for shoulder, abdominal, and chest pain, headache, and toothache differed significantly before and after the first officially confirmed COVID-19 cases (for all, P<.001). In addition, we observed a heterogenous, marked increase or reduction in pain-related search parameters among the most populated regions. CONCLUSIONS As internet searches are a surrogate for public interest, we assume that our data are indicative of an increased incidence of pain after the onset of the COVID-19 pandemic. However, as these increased incidences vary across geographical and anatomical locations, our findings could potentially facilitate the development of specific strategies to support the most affected groups.
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Affiliation(s)
- Istvan-Szilard Szilagyi
- Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria
| | - Torsten Ullrich
- Institute of Computer Graphics and Knowledge Visualisation, Graz University of Technology, Graz, Austria
- Fraunhofer Austria Research GmbH, Graz, Austria
| | - Kordula Lang-Illievich
- Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria
| | - Christoph Klivinyi
- Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria
| | | | - Holger Simonis
- Department of Anesthesiology, Perioperative and Intensice Care Medicine, University Hospital Salzburg, Salzburg, Austria
| | - Helmar Bornemann-Cimenti
- Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria
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Schittek GA, Schwantzer G, Simonis H, Heschl S, Sandner-Kiesling A, Bornemann-Cimenti H. Randomised controlled pilot trial of concepts for analgesia and sedation during placement of peripheral regional anaesthesia before operations. Eur J Anaesthesiol 2021; 38:183-184. [PMID: 33394784 DOI: 10.1097/eja.0000000000001296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Gregor A Schittek
- From the Division of General Anaesthesiology, Emergency and Intensive Care Medicine, Department of Anesthesiology and Intensive Care Medicine, University Hospital of Graz (GAS, HS, HB-C), Institute for Medical Informatics, Statistics and Documentation (GS), Division of Anaesthesiology for Cardiovascular Surgery and Intensive Care Medicine, Department of Anesthesiology and Intensive Care Medicine (SH) and Division of the Special Anaesthesiology, Pain and Intensive Care Medicine, Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria (AS-K)
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Schittek GA, Zoidl P, Eichinger M, Orlob S, Simonis H, Rief M, Metnitz P, Fellinger T, Soukup J. Adsorption therapy in critically ill with septic shock and acute kidney injury: a retrospective and prospective cohort study. Ann Intensive Care 2020; 10:154. [PMID: 33206229 PMCID: PMC7672170 DOI: 10.1186/s13613-020-00772-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 11/07/2020] [Indexed: 12/13/2022] Open
Abstract
Background Haemoadsorption has been described as an effective way to control increased pro- and anti-inflammatory mediators (“cytokine storm”) in septic shock patients. No prospective or randomised clinical study has yet confirmed these results. However, no study has yet prospectively specifically investigated patients in severe septic shock with sepsis-associated acute kidney injury (SA-AKI). Therefore, we aimed to examine whether haemoadsorption could influence intensive care unit (ICU) and hospital mortality in these patients. Furthermore, we examined the influence of haemoadsorption on length of stay in the ICU and therapeutic support. Methods Retrospective control group and prospective intervention group design in a tertiary hospital in central Europe (Germany). Intervention was the implementation of haemoadsorption for patients in septic shock with SA-AKI. 76 patients were included in this analysis. Results Severity of illness as depicted by APACHE II was higher in patients treated with haemoadsorption. Risk-adjusted ICU mortality rates (O/E ratios) did not differ significantly between the groups (0.80 vs. 0.83). We observed in patients treated with haemoadsorption a shorter LOS and shorter therapeutic support such as catecholamine dependency and duration of RRT. However, in multivariate analysis (logistic regression for mortality, competing risk for LOS), we found no significant differences between the two groups. Conclusions The implementation of haemoadsorption for patients in septic shock with acute renal failure did not lead to a reduction in ICU or hospital mortality rates. Despite univariate analysis delivering some evidence for a shorter duration of ICU-related treatments in the haemoadsorption group, these results did not remain significant in multivariate analysis. Trial registration CytoSorb® registry https://clinicaltrials.gov/ct2/show/NCT02312024. December 9, 2014. Database: https://www.cytosorb-registry.org/ (registration for content acquisition is necessary)
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Affiliation(s)
- Gregor A Schittek
- Department of Anaesthesiology and Intensive Care Medicine, Division of General Anaesthesiology and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria.
| | - Philipp Zoidl
- Department of Anaesthesiology and Intensive Care Medicine, Division of General Anaesthesiology and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria
| | - Michael Eichinger
- Department of Anaesthesiology and Intensive Care Medicine, Division of General Anaesthesiology and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria
| | - Simon Orlob
- Department of Anaesthesiology and Intensive Care Medicine, Division of General Anaesthesiology and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria
| | - Holger Simonis
- Department of Anaesthesiology and Intensive Care Medicine, Division of General Anaesthesiology and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria
| | - Martin Rief
- Department of Anaesthesiology and Intensive Care Medicine, Division of General Anaesthesiology and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria
| | - Philipp Metnitz
- Department of Anaesthesiology and Intensive Care Medicine, Division of General Anaesthesiology and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria
| | - Tobias Fellinger
- Austrian Centre for Documentation and Quality Assurance in Intensive Care, Vienna, Austria
| | - Jens Soukup
- Department of Anaesthesiology, Intensive and Palliative Care, Carl-Thiem-Hospital Cottbus, Cottbus, Germany
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Schittek GA, Simonis H, Fischer M, Soukup J. Schwere Schocksymptomatik infolge anaphylaktoider Reaktion auf Ticagrelor. Anasthesiol Intensivmed Notfallmed Schmerzther 2019; 54:630-634. [DOI: 10.1055/a-0901-6613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
ZusammenfassungDie Kasuistik beschreibt den ersten dokumentierten Fall mit einer klinisch gesicherten schweren Anaphylaxie nach Ticagrelor bei einem 76-jährigen männlichen Patienten mit ST-Hebungs-Myokardinfarkt (STEMI).
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Bornemann-Cimenti H, Simonis H, Halb L, Lindbauer N, Fleck S, Rumpold-Seitlinger G, Dorn C. Transcutaneous Peripheral Nerve Stimulation for Occipitalis Nerve Block. Headache 2015; 55:1012-3. [PMID: 26121059 DOI: 10.1111/head.12611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Helmar Bornemann-Cimenti
- Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria
| | - Holger Simonis
- Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria
| | - Larissa Halb
- Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria
| | - Nikki Lindbauer
- Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria
| | - Sabine Fleck
- Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria
| | | | - Christian Dorn
- Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria
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Abstract
Using acupuncture instead of anesthetics to induce analgesia was performed in China many years ago in surgical anesthetization. Although many medical units in China’s cities and rural areas are applying these techniques in operations, it should be pointed out that acupuncture anesthesia is still in the process of development and is of next to no practical and even less scientific value in the western world. However, acupuncture-assisted anesthesia can be useful also in countries other than China.
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Affiliation(s)
- H. Simonis
- Laboratorum der Techn. Hochschule Berlin
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Affiliation(s)
- H. Simonis
- Organ. Laboratorium der Königl. Techn. Hochschule Berlin
| | - Henryk Cohn
- Organ. Laboratorium der Königl. Techn. Hochschule Berlin
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Affiliation(s)
- H. Simonis
- Berlin, Organisches Laboratorium der Kgl. Techn. Hochschule
| | - Hans Schuhmann
- Berlin, Organisches Laboratorium der Kgl. Techn. Hochschule
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Affiliation(s)
- A. Löwenbein
- Organ.‐chem. Laborat. d. Techn. Hochschule zu Berlin
| | - H. Simonis
- Organ.‐chem. Laborat. d. Techn. Hochschule zu Berlin
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Teufel G, Nicolai M, Aisslinger U, Simonis H, Meerpohl HG, Pfleiderer A. [Surgical therapy of progressive or recurrent malignant ovarian tumors]. Geburtshilfe Frauenheilkd 1991; 51:186-93. [PMID: 1711489 DOI: 10.1055/s-2007-1023701] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Out of a total of 120 patients operated on for recurrent ovarian cancer, two at the very best, but possibly not even one, will have a definitive chance of cure. Despite the poor long-term prognosis, as well as the lengthy operation and postoperative treatment involved, it does not seem justified to withhold surgery for recurrent disease totally. In some cases, symptoms can be treated with surgery, such as tumour pain or an impending ileus. In other cases, patients live for 10 years and longer, after multiple operations for relapse, without suffering severe physical symptoms. These are mainly patients with circumscribed, solitary, and very slowly growing tumours, in which cases, it is possible to remove the tumour again and again by surgery. The most relevant prognostic factors include the size of the residual tumour left at the primary operation, the time between the primary operation and the recurrence of the tumour, the type of growth of the recurrent tumour, as well as the extent of the tumour size reduction achieved at the first recurrence operation.
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Affiliation(s)
- G Teufel
- Universitäts-Frauenklinik Freiburg
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Speidel K, Knopp M, Karle W, Maier-Komor P, Simonis H, Hagelberg F, Gerber J, Tandon PN. Evidence for spin-polarized electrons of highly stripped fluorine ions emerging from thin ferromagnetic layers. Phys Rev Lett 1988; 61:2616-2619. [PMID: 10039171 DOI: 10.1103/physrevlett.61.2616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Simonis H, Dincbas M. Using Logic Programming for Fault Diagnosis in Digital Circuits. GWAI-87 11th German Workshop on Artifical Intelligence 1987. [DOI: 10.1007/978-3-642-73005-4_15] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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Simonis H. Extraktionskolonne nach Dr. Ludwig Ziehl und ihre Anwendung für die Entphenolung von Abwässern. Angew Chem Int Ed Engl 1963. [DOI: 10.1002/ange.19630751926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Simonis H. Neue Synthesen auf dem Flavongebiete. Angew Chem Int Ed Engl 1926. [DOI: 10.1002/ange.19260394717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Simonis H. Vereine und Versammlungen. Angew Chem Int Ed Engl 1924. [DOI: 10.1002/ange.19240373109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Meyer H, Simonis H. Literatur. Anal Bioanal Chem 1917. [DOI: 10.1007/bf01470300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Simonis H, Thies FH. Die Bestimmung des Kohlenstoffs auf nassem Wege. Anal Bioanal Chem 1914. [DOI: 10.1007/bf01546573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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